Unit Cost 60,0001 VIP 840,000 420,000 360,0002 Kelas I 600,000 330,000 300,0003 Kelas II 360,000 180,000 150,0004 Kelas III 120,000 90,000 60,000Persalinan Patologis<strong>No</strong> Kelas dr. Ahlidr. Umum Bidan1 VIP 1,260,000 630,000 540,0002 Kelas I 900,000 465,000 450,0003 Kelas II 540,000 270,000 210,0004 Kelas III 180,000 165,000 90,000Abortus Tanpa Curretage<strong>No</strong> Kelas dr. Ahli dr. UmumUnit Cost 60,0001 VIP 840,000 420,0002 Kelas I 600,000 330,0003 Kelas II 360,000 180,0004 Kelas III 120,000 90,000Abortus Dengan Curretage<strong>No</strong> Kelas dr. Ahli dr. Umum1 VIP 1,260,000 630,0002 Kelas I 900,000 465,0003 Kelas II 540,000 270,0004 Kelas III 180,000 165,000Persalinan Dengan Sectio CaesareaKelas jasa medis sc terencana citoVIP Jasa Medis ( dr Operator ) 2,160,000 3,240,000Jasa dr. Anestesi 756,000 1,134,000Jasa Ass. Operator 324,000 486,000Jasa Prwt Anestesi 324,000 486,000Jasa RS 648,000 972,000KELAS I Jasa Medis ( dr Operator ) 1,800,000 2,700,000
Jasa dr. Anestesi 630,000 945,000Jasa Ass. Operator 270,000 405,000Jasa Prwt Anestesi 270,000 405,000Jasa RS 540,000 810,000KELAS II Jasa Medis ( dr Operator ) 1,440,000 2,160,000Jasa dr. Anestesi 504,000 756,000Jasa Ass. Operator 216,000 324,000Jasa Prwt Anestesi 216,000 324,000Jasa RS 432,000 648,000KELAS III Jasa Medis ( dr Operator ) 720,000 1,080,000Jasa dr. Anestesi 252,000 378,000Jasa Ass. Operator 108,000 162,000Jasa Prwt Anestesi 108,000 162,000Jasa RS 216,000 324,000Keterangan :1 Biaya Bahan diperhitungkan sesuai pemakaian2 Resusitasi pada persalinan sectio caesarea besarnya tarif sama pada persalinan patologis14 TARIF KONSULTASI GIZI<strong>No</strong> Uraian Biaya VIP Kelas I Kelas IIUnit cost 60,000Tarif Konsultasi Gizi 12,000 9,000 6,000Keterangan :1 Biaya bahan dan alat diperhitungkan sesuai pemakaian2 Untuk pasien rawat jalan tarif sesuai pasien rawat inap kelas I15 TARIF INSTALASI FARMASI1 Harga jual obat/ perbekalan farmasi = harga netto + ( 20% x harga beli )2 Imbalase resep :- Resep obat racikan Rp = 4,500- Resep obat non racikan Rp 3,00016 TARIF TINDAKAN TERAPI GIGI<strong>No</strong> Uraian Biaya VIP Kelas I Kelas IIUnit Cost II 60,000
- Page 1 and 2: LAMPIRAN :PERDA TENTANG RESTRIBUSNO
- Page 3 and 4: 3 Imunologi 19,200 14,400 9,600Jasa
- Page 5 and 6: Jasa Asisten Medis 19,950 14,963 9,
- Page 7 and 8: 9 TARIF TINDAKAN REHABILITASI MEDIK
- Page 9 and 10: KECILB. SMF KEBIDANAN1. Sterilisasi
- Page 11: 3 Jasa Ass. Operator 40,500 108,000
- Page 15: 3 Jasa Rumah Sakit 20,0004 Jasa Rek
- Page 18 and 19: 60,00015,0007,50018,000Kelas III Pa
- Page 20 and 21: Kelas III68,51345,60027,405141,518K
- Page 22 and 23: 8,000 6,000 3,000 5,5008,000 6,000
- Page 24 and 25: 1,800,000 2,400,000630,000 840,0002
- Page 26 and 27: 1.080.000378.000162.000162.000162.0
- Page 28 and 29: Unit Cost dr. Ahli dr. UmumResusita
- Page 30 and 31: 8,00016,00024,000Kelas III8,0008,00